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Precision Medicine Based on Next-Generation Sequencing and Master Controllers

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Pancreatic Cancer

Abstract

Despite decades of research and efforts at improving survival, pancreatic ductal adenocarcinoma (PDA) has become the third leading cause of cancer-related deaths in the United States. In fact, by 2020, it is projected to become the second leading cause of cancer-related deaths in the United States. Personalized, or precision, medicine has resulted in improving patient outcomes in other tumor systems. However, for pancreatic cancer patients, there are a limited number of evidence-based targeted therapeutic options that are currently available. Significant advances in DNA sequencing technology have resulted in the identification of a number of genetic mutations and the delineation of core signaling pathways important in PDA. This has subsequently resulted in an advanced understanding of the genetic drivers of the progression of this disease. Facile sequencing technology has moved the field closer to a personalized approach to treating pancreatic cancer. Improvements to the personalized therapy approach will likely result from several factors including the delivery of tumor sequencing results in a clinically relevant timeframe, the development of better targeted drugs, and perhaps a molecular-targeted approach to aspects of PDA biology beyond mutations in the deoxyribonucleic acid (DNA). These advances will allow clinicians to enroll patients in appropriate-matched clinical trials in a timely manner. In this chapter, the opportunities and limitations of a targeted, personalized approach to treating PDA will be discussed.

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Author information

Authors and Affiliations

  1. Departments of Surgery and the Jefferson Pancreas, Biliary and Related Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA

    Katerina Dukleska, Charles J. Yeo & Jonathan R. Brody

  2. Sidney Kimmel Medical College and Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA

    Katerina Dukleska, Charles J. Yeo & Jonathan R. Brody

  3. Division of Hematology and Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA

    Michael J. Pishvaian

Authors
  1. Katerina Dukleska
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  2. Charles J. Yeo
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  3. Michael J. Pishvaian
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  4. Jonathan R. Brody
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Corresponding author

Correspondence to Jonathan R. Brody .

Editor information

Editors and Affiliations

  1. Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany

    John P. Neoptolemos

  2. Division of Research Department of Surgery and Genomic Sciences and Precision Medicine Center (GSPMC), Medical College of Wisconsin, Milwaukee, Wisconsin, USA

    Raul Urrutia

  3. Division of Medical Oncology, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA

    James L. Abbruzzese

  4. Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany

    Markus W. Büchler

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Dukleska, K., Yeo, C.J., Pishvaian, M.J., Brody, J.R. (2018). Precision Medicine Based on Next-Generation Sequencing and Master Controllers. In: Neoptolemos, J., Urrutia, R., Abbruzzese, J., Büchler, M. (eds) Pancreatic Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-7193-0_71

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